Triunfo Stefania, Ferrazzani Sergio, Lanzone Antonio, Scambia Giovanni
Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
Eur J Obstet Gynecol Reprod Biol. 2015 Jun;189:91-5. doi: 10.1016/j.ejogrb.2015.03.030. Epub 2015 Apr 9.
Due to continuous rise of cesarean section (CS) rate in recent decades to analyze this trend using Robson Ten Group Classification System (RTGCS) and identify the main contributor of the CS rate in an Italian tertiary level hospital.
A total of 17,886 deliveries in six (1998, 1999, 2004, 2005, 2010, 2011) of a 13-year period was analyzed using RTGCS.
From 1998 to 2011 a rising CS birth rate from 38.7 to 43.7 per 100 births was calculated (p<0.001) in association with a significant reduction of vaginal delivery (VD) (59.7 vs. 53.7%; p<0.001). In multiparous women with a previous CS (Group 5) a repeat CS was performed routinely, resultant the most contributor of CS rate (15.4 vs. 16.2%; p<0.001). Nulliparous women with singleton cephalic full-term pregnancy in spontaneous or induced labor onset resulted the second contributor (Group 1, 3.3 vs. 4.7%; p<0.001; Group 2, 3.6 vs. 4.5%; p<0.001).
The RTGCS allows easy identification of the leading contributing patients groups. To propose and evaluate interventions for improving the labor management in nulliparous women and promote vaginal delivery after cesarean (VBAC) could help to mitigate further increases in the future.
鉴于近几十年来剖宫产率持续上升，使用罗布森十组分类系统（RTGCS）分析这一趋势，并确定一家意大利三级医院剖宫产率的主要促成因素。
使用RTGCS对13年期间六个年份（1998年、1999年、2004年、2005年、2010年、2011年）的17886例分娩进行分析。
从1998年到2011年，计算得出剖宫产出生率从每100例出生38.7例上升至43.7例（p<0.001），同时阴道分娩（VD）显著减少（59.7%对53.7%；p<0.001）。在有既往剖宫产史的经产妇中（第5组），常规进行再次剖宫产，这是剖宫产率的最大促成因素（15.4%对16.2%；p<0.001）。单胎头位足月妊娠、自然发动或引产的初产妇是第二大促成因素（第1组，3.3%对4.7%；p<0.001；第2组，3.6%对4.5%；p<0.001）。
RTGCS有助于轻松识别主要的促成患者群体。提出并评估改善初产妇分娩管理和促进剖宫产术后阴道分娩（VBAC）的干预措施，可能有助于在未来缓解剖宫产率的进一步上升。
